212 (219) ADJUSTMENT REASON (161.91)

Name	Value
CODE	212
STATUS EFFECTIVE DATE	2007-11-05 00:00:00 STATUS: ACTIVE FEE USE: APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: Administrative surcharges are not covered
SUSPENSION DESCRIPTION	Administrative surcharges are not covered
REMITTANCE REMARK
CORE SCENARIO	Billed Service Not Covered
ADJUSTMENT GROUP